“互联网+”信息化健康管理系统在预防乳腺癌 患者术后淋巴水肿中的应用

目的 探讨“互联网+”信息化健康管理系统在预防乳腺癌患者术后淋巴水肿中的应用效果。方法 选取2018年1月至2018年11月威海市立医院乳腺癌根治术后367例患者作为研究对象，采用随机数表法分成对照组（183例）和观察组（184例）。对照组予以传统宣教方式，观察组在此基础上予以“互联网+”的信息化健康管理方式，比较两组患者术后淋巴水肿防护知识知晓率、落实率，患肢肿胀情况，因淋巴水肿再入院率及护理满意度。结果 观察组患者的淋巴水肿防护知识知晓率和护理满意度显著高于对照组，患肢水肿程度显著低于对照组（均P＜0.05），而因淋巴水肿再入院率两组差异无统计学意义（P＞0.05）。结论 “互联网+”信息化健康管理系统在预防乳腺癌患者术后患肢淋巴水肿方面具有较好效果，提高了患者的淋巴水肿防护知识知晓率、落实率和护理满意度，减少了淋巴水肿发生率，具有较好的推广价值。     

成都市10至16岁双生子行为问题调查

目的了解10～16岁双生子儿童行为问题的流行病学特征,为双生子儿童行为问题的防治提供依据。方法采用多级随机抽样的方法在成都市随机选取64对10～16岁的双生子,使用Achenbach儿童行为量表评定其行为问题,估算双生子儿童行为问题的发生率及性别、卵型分布特征。结果 10～16岁双生子的行为问题发生率为6.25%,低于全国非双生子行为问题的流行病学调查结果(P=0.004 5);不同性别、不同卵性双生子之间行为问题发生率无统计学差异(P=0.891;P=0.258);在双生子儿童的行为问题中,以交往不良为主,占总行为问题的38.46%。结论 10～16岁双生子的行为问题发生率低于非双生子;在双生子儿童的行为问题中,以交往不良为主。     

超声心动图观察雄激素替代治疗改善慢性心力衰竭雄性大鼠左室收缩功能

目的自身对照研究雄激素替代治疗前后大鼠的心功能状况.方法二维超声结合定量组织速度成像(QT-VI)技术检测四种不同处理(对照组、阿霉素组、睾丸切除 阿霉素组和睾丸切除 阿霉素 雄激素组)大鼠的心脏,测量常用心功能参数,脱机分析后室间隔和左室侧壁二尖瓣环处的速度曲线,记录收缩期峰值速度Vs.结果睾丸切除 阿霉素 雄激素组左室短轴缩短率和二尖瓣环平均峰值速度比睾丸切除 阿霉素组增高,差异有显著性意义.结论雄激素补充治疗能够改善激素水平低下的充血性心力衰竭大鼠的左室收缩功能.定量组织速度成像技术是评价大鼠心血管疾病模型心功能的一个新方法.     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

胆道镜治疗胆道术后残余结石

目的探讨胆道镜在治疗胆道残石方面的临床意义。方法对20例胆道术后残余结石病人均行纤维胆道镜治疗。结果20例胆道术后残余结石患者经纤维胆道镜治疗，取石成功18例，共53例次；2例因窦道闭合取石失败。结论纤维胆道镜治疗肝内胆管残余结石效果好，安全易行。     

自血疗法对寻常型痤疮患者外周血中CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度的影响

目的观察自血疗法对寻常型痤疮患者外周血中CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度的影响,初步探讨自血疗法治疗寻常型痤疮的部分抗炎机制。方法选取30例寻常型痤疮患者为治疗组,另在本院招募健康志愿者20例作为对照组。分析治疗组采用自血疗法前、后外周血CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度,并与对照组比较。结果治疗组患者TLR2表达与血清IL-8、TNF-α浓度呈正相关(P<0.05)。治疗组干预前的外周血中CD14^+单核细胞TLR2表达及血清IL-8、TNF-α浓度均高于对照组及干预后(P=0.000)。结论TLR2的表达及血清IL-8、TNF-α浓度与寻常型痤疮的发病相关。自血疗法可通过下调寻常型痤疮患者外周血CD14^+单核细胞TLR2的表达,减少血清IL-8、TNF-α的分泌,从而抑制炎症反应的发生。     

TGF-beta switches from tumor suppressor to prometastatic factor in a model of breast cancer progression

The TGF-beta signaling network plays a complex role in carcinogenesis because it has the potential to act as either a tumor suppressor or a pro-oncogenic pathway. Currently, it is not known whether TGF-beta can switch from tumor suppressor to pro-oncogenic factor during the course of carcinogenic progression in a single cell lineage with a defined initiating oncogenic event or whether the specific nature of the response is determined by cell type and molecular etiology. To address this question, we have introduced a dominant negative type II TGF-beta receptor into a series of genetically related human breast-derived cell lines representing different stages in the progression process. We show that decreased TGF-beta responsiveness alone cannot initiate tumorigenesis but that it can cooperate with an initiating oncogenic lesion to make a premalignant breast cell tumorigenic and a low-grade tumorigenic cell line histologically and proliferatively more aggressive. In a high-grade tumorigenic cell line, however, reduced TGF-beta responsiveness has no effect on primary tumorigenesis but significantly decreases metastasis. Our results demonstrate a causal role for loss of TGF-beta responsiveness in promoting breast cancer progression up to the stage of advanced, histologically aggressive, but nonmetastatic disease and suggest that at that point TGF-beta switches from tumor suppressor to prometastatic factor.     

降钙素基因相关肽对大鼠主动脉内皮剥脱的保护作用

为研究降钙素基因相关肽在防止动脉内膜损伤后平滑肌细胞增殖所致再狭窄中的作用机制，采用内皮剥脱、血管条灌流和放射免疫测定法测定了环磷一酸尿苷、降钙素基因相关肽和内皮素水平。结果发现，内皮剥脱后两周，血浆及主动脉组织降钙素基因相关肽含量增加（前者对照组为9．2±1．7，去内皮组为14．1±2．0ng／L；后者对照组为7．4±1．4，去内皮组为12．2±2．0ng／g）。应用外源性降钙素基因相关肽（25μg/Kg）可明显改善损伤血管对乙酰胆碱的内皮依赖性舒张反应；促进去内皮血管壁一氧化氮的合成；增加主动脉组织内cGMP的含量（对照组4．4±0．5，去内皮组2．0±0．5，降钙素基因相关肽组3．3±0．5ng/g；P＜0．01），减少内皮素的生成（P＜0．01），抑制损伤部位的内膜过度憎生（P＜0．01）．提示外源性降钙素基因相关肽可通过促进内皮的修复、抑制内膜的过度增殖而防止剥脱血管的再狭窄。     

糖尿病兔肾小管间质损伤标志物变化及长春新碱的干预作用

目的 观察糖尿病兔肾小管间质损伤标志物变化及长春新碱对其影响。方法 日本大白兔随机分成正常对照组（C组）、糖尿病组（DM组）、糖尿病长春新碱治疗组（DV组）；耳缘静注射四氧嘧啶造成兔糖尿病模型，DV组每周予一次长春新碱耳缘静脉注射；胰岛素控制DM组、DV组血糖16.0-25.0 mmol/L.第8周、第12周时分别测各组半数兔血糖、肾重、体重、尿视黄醇结合蛋白（RBP）、N-乙酰-β-D-氨基葡萄糖苷酶（NAG）。结果 给药后72h DV组、DM组血糖明显升高形成稳定糖尿病模型；第8周、第12周时，DV组体重明显高于DM组（P〈0.05）、肾重/体重值明显2低于DM组（P〈0.05）,DM组尿RBP、NAG明显高于对照组（P〈0.05）,DV组尿RBP、NAG均明显低于DM组（P〈0.05）.结论 糖尿病兔早期存在肾小管间质损伤，长春新碱可减轻糖尿病兔肾小管间质损伤，降低肾重/体重值。     

老年非体外循环下冠状动脉旁路移植术后认知功能障碍的临床研究

目的探讨老年非体外循环下冠状动脉旁路移植术(OPCABG)术后认知功能障碍(POCD)的发病情况及其危险因素,并分析320排CT评估的脑血管功能情况与POCD的相关性。方法选择行OPCABG的老年患者213例,并根据是否出现POCD分为病例组28例和对照组185例,行320排CT检查、评估脑血管功能、神经系统和认知功能;术后14d再次进行评估,对比分析POCD的危险因素和CT脑灌注成像各参数与POCD的关系。结果与对照组比较,病例组既往脑血管病、糖尿病、头颅CT血管造影重度狭窄和CT脑灌注异常均明显升高(P<0.01)。多因素logistic回归分析显示,既往脑血管病史(OR=1.837,95%CI:1.075~3.141,P=0.026)和脑灌注异常(OR=3.224,95%CI:2.073~5.013,P=0.000)为POCD的独立危险因素。结论早期发现脑血管狭窄、脑灌注不良以及维持血糖平稳对于降低POCD的发生有重要意义。